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Hormone receptor status, tumor characteristics, and prognosis: a prospective cohort of breast cancer patients.
Breast Cancer Res. 2007; 9(1):R6.BC

Abstract

BACKGROUND

Breast cancer patients with tumors that are estrogen receptor (ER)-positive and/or progesterone receptor (PR)-positive have lower risks of mortality after their diagnosis compared to women with ER- and/or PR-negative disease. However, few studies have evaluated variations in the risks of breast cancer-specific mortality across ER/PR status by either demographic or clinical characteristics.

METHODS

Using data from 11 population-based cancer registries that participate in the SEER (Surveillance, Epidemiology, and End Results) program, 155,175 women at least 30 years old with a primary diagnosis of invasive breast carcinoma from 1990 to 2001 were included in the study. Associations between joint hormone receptor status and breast cancer mortality risk within categories of diagnosis age, diagnosis year, race/ethnicity, histologic tumor type, stage, grade, size, and axillary lymph node status were evaluated using the Cox proportional hazards model.

RESULTS

Compared to ER+/PR+ cases, elevations in risk of mortality were observed across all subcategories of age at diagnosis, ranging from 1.2- to 1.5-fold differences for ER+/PR- cases, 1.5- to 2.1-fold differences for ER-/PR+ cases, and 2.1- to 2.6-fold differences for ER-/PR- cases. Greater differences were observed in analyses stratified by grade; among women with low-grade lesions, ER-/PR- patients had a 2.6-fold (95% confidence interval [CI] 1.7 to 3.9) to 3.1-fold (95% CI 2.8 to 3.4) increased risk of mortality compared to ER+/PR+ patients, but among women with high-grade lesions, they had a 2.1-fold (95% CI 1.9 to 2.2) to 2.3-fold (95% CI 1.8 to 2.8) increased risk.

CONCLUSION

Compared to women with ER+/PR+ tumors, women with ER+/PR-, ER-/PR+, or ER-/PR- tumors experienced higher risks of mortality, which were largely independent of the various demographic and clinical tumor characteristics assessed in this study. The higher relative mortality risks identified among ER-/PR- patients with small or low-grade tumors raise the question of whether there may be a beneficial role for adjuvant chemotherapy in this population.

Authors+Show Affiliations

Department of Epidemiology, University of Washington, Box 356113, 1959 NE Pacific St, Seattle, WA 98195, USA. ldunnwal@u.washington.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17239243

Citation

Dunnwald, Lisa K., et al. "Hormone Receptor Status, Tumor Characteristics, and Prognosis: a Prospective Cohort of Breast Cancer Patients." Breast Cancer Research : BCR, vol. 9, no. 1, 2007, pp. R6.
Dunnwald LK, Rossing MA, Li CI. Hormone receptor status, tumor characteristics, and prognosis: a prospective cohort of breast cancer patients. Breast Cancer Res. 2007;9(1):R6.
Dunnwald, L. K., Rossing, M. A., & Li, C. I. (2007). Hormone receptor status, tumor characteristics, and prognosis: a prospective cohort of breast cancer patients. Breast Cancer Research : BCR, 9(1), R6.
Dunnwald LK, Rossing MA, Li CI. Hormone Receptor Status, Tumor Characteristics, and Prognosis: a Prospective Cohort of Breast Cancer Patients. Breast Cancer Res. 2007;9(1):R6. PubMed PMID: 17239243.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hormone receptor status, tumor characteristics, and prognosis: a prospective cohort of breast cancer patients. AU - Dunnwald,Lisa K, AU - Rossing,Mary Anne, AU - Li,Christopher I, PY - 2006/08/21/received PY - 2007/01/09/revised PY - 2007/01/19/accepted PY - 2007/1/24/pubmed PY - 2007/5/11/medline PY - 2007/1/24/entrez SP - R6 EP - R6 JF - Breast cancer research : BCR JO - Breast Cancer Res. VL - 9 IS - 1 N2 - BACKGROUND: Breast cancer patients with tumors that are estrogen receptor (ER)-positive and/or progesterone receptor (PR)-positive have lower risks of mortality after their diagnosis compared to women with ER- and/or PR-negative disease. However, few studies have evaluated variations in the risks of breast cancer-specific mortality across ER/PR status by either demographic or clinical characteristics. METHODS: Using data from 11 population-based cancer registries that participate in the SEER (Surveillance, Epidemiology, and End Results) program, 155,175 women at least 30 years old with a primary diagnosis of invasive breast carcinoma from 1990 to 2001 were included in the study. Associations between joint hormone receptor status and breast cancer mortality risk within categories of diagnosis age, diagnosis year, race/ethnicity, histologic tumor type, stage, grade, size, and axillary lymph node status were evaluated using the Cox proportional hazards model. RESULTS: Compared to ER+/PR+ cases, elevations in risk of mortality were observed across all subcategories of age at diagnosis, ranging from 1.2- to 1.5-fold differences for ER+/PR- cases, 1.5- to 2.1-fold differences for ER-/PR+ cases, and 2.1- to 2.6-fold differences for ER-/PR- cases. Greater differences were observed in analyses stratified by grade; among women with low-grade lesions, ER-/PR- patients had a 2.6-fold (95% confidence interval [CI] 1.7 to 3.9) to 3.1-fold (95% CI 2.8 to 3.4) increased risk of mortality compared to ER+/PR+ patients, but among women with high-grade lesions, they had a 2.1-fold (95% CI 1.9 to 2.2) to 2.3-fold (95% CI 1.8 to 2.8) increased risk. CONCLUSION: Compared to women with ER+/PR+ tumors, women with ER+/PR-, ER-/PR+, or ER-/PR- tumors experienced higher risks of mortality, which were largely independent of the various demographic and clinical tumor characteristics assessed in this study. The higher relative mortality risks identified among ER-/PR- patients with small or low-grade tumors raise the question of whether there may be a beneficial role for adjuvant chemotherapy in this population. SN - 1465-542X UR - https://www.unboundmedicine.com/medline/citation/17239243/Hormone_receptor_status_tumor_characteristics_and_prognosis:_a_prospective_cohort_of_breast_cancer_patients_ L2 - https://breast-cancer-research.biomedcentral.com/articles/10.1186/bcr1639 DB - PRIME DP - Unbound Medicine ER -